Medicine and Health Commons^™

Sexual And Reproductive Health Access Among Racial/Ethnic Minority College Students, Srithanvi Pasunuri

Honors Undergraduate Theses

Sexual and reproductive health (SRH) is critical for individual well-being, yet significant disparities in access persist among racial and ethnic minority college students in the United States. These inequities, driven by systemic barriers such as financial constraints, cultural stigmas, and inadequate campus resources, contribute to higher rates of unintended pregnancies, sexually transmitted infections (STIs), and poor health outcomes within these populations. This systematic review aims to identify and synthesize existing literature on the barriers to SRH access for racial and ethnic minority college students, explore how cultural, social, and institutional factors influence service utilization, and assess interventions proven effective in …

Barriers To Postpartum Depression Treatment: Availability And Accessibility Of Maternal Behavioral Health-Inclusive Support Groups For Low-Income Populations, Radhika S. Venkatesan

Honors Undergraduate Theses

The maternal health crisis is a prevalent and concerning issue in the United States. The lack of efficient availability and accessibility to health care services plays a significant role in augmenting this problem. One health care service that is often understudied is support groups, for prevalent issues like postpartum depression. Considering the socioeconomic burdens of low-income mothers, this paper analyzed the accessibility and availability of maternal health support groups across counties in Florida, with varying amounts of individuals below the federal poverty level (%BPL). Essentially, Florida counties were divided into one of four categories depending on their %BPL. A Fisher’s …

Out-Of-Pocket Healthcare Expenses Are Associated With Food Insecurity Among South Dakotan Families Who Have Children With Disabilities, Halie E. Kruid

Health and Nutritional Sciences Graduate Students Plan B Capstone Projects

Background
In 2023, 17.9 percent (6.5 million) of households with children experienced household food insecurity, i.e., an inability to acquire enough food to meet household members’ needs. Many socioeconomic factors can influence food security status, such as environmental conditions, social factors, and financial costs. Families with children with disabilities (CWD) may be at higher risk for food insecurity due to additional financial stressors related to these children’s care.
Purpose
The purpose of this study was to determine the prevalence of food insecurity, as well as the medical and financial factors associated with an increased food insecurity prevalence, among South Dakota …

Social Determinants Of Mental Health Outcomes, Ariana Fein

Honors Theses

Mental health disorders, particularly anxiety and depression, are a growing global concern with profound consequences on individuals' well-being and societal functioning. The burden of these disorders is not only psychological but also economic, affecting quality of life. Mental health outcomes are heavily influenced by a range of social determinants, such as financial status, education, and access to healthcare. While extensive research has focused on WEIRD (Western, Educated, Industrialized, Rich, Democratic) countries, there remains a significant gap in understanding how these determinants affect mental health in low-resource settings or non-WEIRD countries. This study aimed to address this gap by exploring the …

Rwanda's Natural Remedies: A Fresh Look At The Fight Against Malaria, Leandre Nsabimana Ndisanze

Pomona Senior Theses

Malaria remains one of the most devastating parasitic diseases globally, disproportionately affecting sub-Saharan Africa, where Rwanda continues to face high transmission rates and rising resistance to conventional interventions. Despite decades of control efforts, the emergence of drug-resistant Plasmodium falciparum and insecticide-resistant Anopheles mosquitoes threatens to reverse recent gains. This research responds to the urgent need for sustainable and culturally relevant alternatives by exploring the therapeutic potential of Rwandan traditional medicinal plants. These indigenous remedies, long used by local healers, offer an underexplored reservoir of bioactive compounds that may provide the basis for novel antimalarial drugs.

The central hypothesis of this …

An In-Depth Review Of Euthanasia-Related Practices, Arguments For/Against Them, And Proposed Solutions For Their Most Glaring Legal/Ethical Problems, Macon Plecha

Williams Honors College, Honors Research Projects

This paper’s goal is to cover the topic of euthanasia-related practices at great length. Terminology, history, and current programs around the world are discussed first, with the last point covering a wide geographical range: Colombia, Japan, Israel, and Africa, to name a few outside of the Western world standard. Arguments for and against euthanasia-related practices are explored. Within these arguments, several pressing legal and ethical issues arise, and the most severe of these are expanded on through the offering of potential solutions: how to handle stand-alone psychiatric cases, how to improve advanced directives and poor reporting rates, and how to …

Breaking Ground On Self-Efficacy: A Qualitative Exploration Of Intimate Partner Violence Survivors’ Experiences With Therapeutic Horticulture, Rachel Marie Reeves

Theses and Dissertations--Sociology

This dissertation explores how participation in a Therapeutic Horticulture program may support the self-efficacy of survivors of Intimate Partner Violence. Through a thematic analysis of interviews with 45 women living at a domestic violence shelter in Lexington, Kentucky, this study investigates whether and how gardening activities contributed to participants’ belief in their abilities to shape outcomes in their lives.

Findings are organized around Bandura’s four sources of self-efficacy: enactive mastery experiences, vicarious experience, verbal persuasion, and physiological/affective states. These insights contribute to feminist criminology and trauma-informed care literature by illuminating the transformative potential of nature-assisted healing programs.

Emplacing Deaths Of Despair Within The Rural Mortality Penalty: The Spatial Inequality Of Violent Death Across Rural America, Cameron A. Mcalister

Theses and Dissertations--Sociology

American life expectancy continues to diverge from most developed nations. Literature spanning several fields of scholarship has documented an uneven distribution of life expectancy between social groups and across geographic contexts. Frameworks such as “Deaths of Despair” and the rural mortality penalty describe the declining health trends among working class whites and rural America. But, conceptual development around these frameworks is still limited. This dissertation utilizes a rural sociological approach to bridging the gap between the Deaths of Despair framework and the rural mortality penalty by examining violent death patterns across diverse rural contexts. In doing so, I incorporate several …

Toward Inclusive Care: Enhancing Lgbtq+ Adolescents’ Experiences In Primary Care, Rutwa Shah

Honors Undergraduate Theses

LGBTQ+ adolescents face significant inequities in healthcare access and health outcomes, yet little is known about how they engage with routine pediatric care, where parental presence and clinician dynamics often influence their ability to access affirming services. While prior research has emphasized the importance of inclusive environments and clinician communication, few studies center the voices of LGBTQ+ youth in clinical settings. This study explored how LGBTQ+ adolescents manage sexual/gender identity disclosure, trust, and communication with primary care clinicians. This study draws on data from The VIBES Study: Viewpoints on Improving Bonds Between Health Experts and Sexual and Gender Minority Youth. …

Barriers To Healthcare Utilization Among Undergraduate Students: A Gender Identity Perspective, Akhila Damarla

Honors Undergraduate Theses

The transition to college can be a crucial period of one’s life as one gains new and increased responsibilities, including managing their own healthcare. Although campus health services are available, undergraduate students have been found to often underutilize these resources due to barriers such as financial instability, lack of insurance, and identity-based disparities. While examining the current literature on this topic,there is a gap in exploring how the role of gender identity interacts with these barriers. This study addresses this gap by analyzing secondary data from the American College Health Association’s National College Health Assessment (ACHA-NCHA). Results revealed that transgender …

Access To And Utilization Of Dental Care Services By Older Adults In Nigeria: Barriers And Facilitators, Sunkanmi Folorunsho, Victor Ajayi, Munirat Sanmori, Medinah Suleiman, Raji Abdullateef, Abdulazeez Abdulganiyu

Department of Sociology: Faculty Publications

Aims: Nigeria’s rapidly aging population presents urgent challenges for the healthcare system, particularly in oral health, which remains an overlooked aspect of well-being. While older adults are especially vulnerable to dental issues such as tooth loss, periodontal disease, and oral pain, access to care remains limited due to systemic, economic, and cultural barriers. This qualitative study explored the lived experiences of older Nigerians in accessing and utilizing dental care, with the goal of identifying key barriers, facilitators, and policy-relevant insights.

Methods: Fifteen participants aged 50–83 years were purposively selected from urban and peri-urban areas of Ilorin, North- Central …

Navigating Sexual And Gender Diversity: A Quality Improvement Project To Increase Provider Cultural Competencies For Sexual And Gender Minorities In Mental Health Outpatient Facilities, Shermeen Chandani

Doctor of Nursing Practice Final Project Abstract

Purpose: Sexual and gender minority (SGM) populations experience healthcare disparities related to stigma, discrimination, and limited provider cultural competency. In outpatient psychiatric settings, non-affirming practices can negatively affect patient engagement, trust, and continuity of care. This quality improvement project aimed to enhance staff sexual and gender minority cultural competency (SGMCC) and strengthen affirming clinical processes.

Background: The project was implemented across two outpatient psychiatric clinics with approximately 28 multidisciplinary staff members. At baseline, no formal SGM cultural competency training or standardized documentation practices for preferred names and pronouns existed.

Methodology: A Plan–Do–Study–Act framework with a pre/post-test design was used. The …

The Affordable Care Act And The For-Profit Congregate Care Industry: How Good Policy Intent Turned A Fringe Industry Into A Taxpayer-Funded Multi Billion Dollar Industry, Erin Viehmann

College of Graduate Studies: Theses & Dissertations

The Affordable Care Act significantly transformed the for-profit congregate care (FPCC) industry, which provides residential treatment for adolescents with behavioral and mental health issues. This study analyzes financial records from Universal Health Services (UHS), the largest provider in the industry, to examine how healthcare policy changes and economic conditions affected the industry's growth and funding structure. Through analysis of SEC Form 10-K filings from 2006-2016, the research documents how the ACA's mental health coverage mandates created new revenue streams that enabled dramatic industry expansion. Findings show that following ACA passage in 2010, UHS more than doubled its behavioral health capacity …

Organizational And Structural Factors In Building The Therapeutic Alliance In A Work Rehabilitation Program With Injured Immigrant Workers In Quebec, Daniel Côté, Maude Arsenault, Jessica Dubé

Études primaires

Abstract

The therapeutic alliance is central to occupational rehabilitation, particularly for immigrant workers who face unique challenges of migration and of social and occupational integration. This study explores the development and maintenance of this alliance between immigrant workers with compensated work injuries and their care providers during work rehabilitation. Using ethnography, semi-structured interviews, and focus groups, the qualitative case study involved 7 injured immigrant workers and their interdisciplinary clinical team. The study identified several factors that weakened the alliance, including administrative complexity, conflicting views on pain and disability, cultural stereotypes, and interorganizational communication issues. Many of these challenges were systemic …

A Feminist Evaluation Of The Joint Programme: Assessing The Cultural Sensitivity Of Unicef And Unfpa's Strategies On Female Genital Cutting/Circumcision In Senegal And Nigeria, Coumba Soumare

All Graduate Theses, Dissertations, and Other Capstone Projects

Female Genital Cutting/Circumcision (FGC) encompasses procedures involving the partial or total removal of female external genitalia or other genital injuries, performed for non-medical reasons. Typically carried out on young girls, often between infancy and age 15, FGC is widely condemned in global discourse as a harmful and barbaric practice. However, within certain cultures, it is viewed as a rite of passage or a necessary tradition. I argue that to effectively address FGC, organizations must adopt a culturally sensitive approach. This research examines the United Nations Children’s Fund’s (UNICEF) and the United Nations Population Fund’s (UNFPA) initiatives in Senegal and Nigeria. …

Stability Of Cognitive Ability And Effect Of Education Across 58 Years: A Project Talent Aging Study, Thalida Em Arpawong, Jimi Huh, Tara Gruenewald, Gwenith G. Fisher, Jennifer J. Manly, Dominika Seblova, Kelly Peters, Margaret Gatz

Psychology Faculty Articles and Research

We assessed the degree to which individuals retain cognitive abilities from adolescence through older adulthood, and whether more education associates with better retention in some more than others, after adjusting for adolescent cognitive ability. We also evaluated whether benefits associated with education differ for those with lower or higher cognitive scores in adolescence, or women or men. Data came from the Project Talent Aging Study, and included measures of abstract reasoning, mathematics, visualization in two dimensions, and recognition memory in 1960 and 2018 (n=2,032; age range 71 to 79). Confirmatory factor analysis was used to fit one-factor (cognitive ability factor, …

Biological Aging Pathways That Underlie Life Course Socioeconomic Disparities In Physical Function And Longevity, Tara Gruenewald, Naomi Podber

Psychology Faculty Articles and Research

The poorer functioning and greater morbidity and mortality risk in those with greater life course socioeconomic disadvantage has led to the search for the biological processes that underlie these associations, including accelerated cellular and system aging. Our study examines whether a DNA methylation profile of the pace of biological aging (DunedinPACE) and a multi-system index of physiological dysregulation (allostatic load (AL)) mediate associations between life course socioeconomic disadvantage (SESDIS) and both physical function (gait speed, chair stand time) and survival. Data are from the Midlife in the U.S. Study (N=1,295, age 26–86, 55.4% female, 69.0% white). Measures included a multi-indicator …

The Texas Electorate's Views Of Health Care As A Human Right, Community Health Centers, And Certain Matters Of The Health Care Safety Net, Scott Elphingstone

Graduate Liberal Studies Theses and Dissertations

In a country in which the government does not recognize a right to health care,social safety nets are the last hope for persons without insurance or other means to pay for needed care. In United States, community health centers, hospital emergency rooms, and private charities comprise that safety net. Community health centers offer a practicable alternative for politicians and citizens who want to help improve the lives of persons who struggle to access health care. This dissertation reviews the political history of community health centers from their founding as part of the War on Poverty in the 1960s through Democratic …

Learning To Be An Autistic Therapist: Personal Steps Towards An Autism-Affirming Psychotherapy, Sasha D. Strong

Ought: The Journal of Autistic Culture

How can Autistic therapists understand and support themselves, and how can this help them support their clients? In this paper, I recount my personal journey of healing and growth as an Autistic psychotherapist, 16 months after self-identification. Here is an overview of conceptual frameworks from #actuallyautistic authors, critical theory, queer theory, and social justice that I have found helpful. I also share some of the therapeutic and wellness approaches that have been important to me, including mindfulness and bodyfulness. Organic knowing has been pivotal for me in discerning between masking and aliveness, and regaining a choice around masking behaviors. This …

The Camden Study - A Pregnancy Cohort Study Of Pregnancy Complications And Birth Outcomes In Camden, New Jersey, Usa., Stephanie Shiau, Xinhua Chen, Ayana April-Sanders, Ellen C Francis, Shristi Rawal, Megan Hansel, Kehinde Adeyemi, Zorimar Rivera-Núñez, Emily S Barrett

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women.

METHODS: From 1985-2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White …